Wittmaack MCN, Conceição MEBAM, Vera MCM, Faccini RI, Sembenelli G, Montanhim GL, de Menezes MP, Rocha FDL, Aires LPN, Moraes PC. Comparative evaluation of three laparoscopic cholecystectomy techniques in rabbit's model.
Acta Cir Bras 2023;
38:e383523. [PMID:
38055391 PMCID:
PMC10691173 DOI:
10.1590/acb383523]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/23/2023] [Indexed: 12/08/2023] Open
Abstract
PURPOSE
The aim of this randomized study was to compare the complications and perioperative outcome of three different techniques of laparoscopic cholecystectomy (LC). Changes in the liver function test after LC techniques were investigated. Also, we compared the degree of postoperative adhesions and histopathological changes of the liver bed.
METHODS
Thirty rabbits were divided into three groups: group A) Fundus-first technique by Hook dissecting instrument and Roeder Slipknot applied for cystic duct (CD) ligation; group B) conventional technique by Maryland dissecting forceps and electrothermal bipolar vessel sealing (EBVS) for CD seal; group C) conventional technique by EBVS for gallbladder (GB) dissection and CD seal.
RESULTS
Group A presented a longer GB dissection time than groups B and C. GB perforation and bleeding from tissues adjacent to GB were similar among tested groups. Gamma-glutamyl transferase and alkaline phosphatase levels increased (p ≤ 0.05) on day 3 postoperatively in group A. By the 15th postoperative day, the enzymes returned to the preoperative values. Transient elevation of hepatic transaminases occurred after LC in all groups. Group A had a higher adherence score than groups B and C and was associated with the least predictable technique.
CONCLUSIONS
LC can be performed using different techniques, although the use of EBVS is highly recommended.
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